<?xml version="1.0" encoding="UTF-8"?>
<table class="container" cellpadding="0" cellspacing="3">
  <tr>
    <td colspan="2" id="content"/>
  </tr>
  <tr>
    <td id="left">
      <div class="EVALUATION  ">
        <span class="label">Disfuncion neurologica:</span>
        <span class="content">
          <div class="ELEMENT ELEMENT_DV_BOOLEAN ">
            <span class="label">¿Presenta alteraciones?:</span>
            <span class="content">
              <label class="field_449"/>
            </span>
          </div>
          <div class="CLUSTER  ">
            <span class="label">Pupilas:</span>
            <span class="content">
              <div class="ELEMENT ELEMENT_DV_BOOLEAN ">
                <span class="label">¿Pupilas anormales?:</span>
                <span class="content">
                  <label class="field_450"/>
                </span>
              </div>
              <div class="CLUSTER  ">
                <span class="label">Grado de dilatacion:</span>
                <span class="content">
                  <div class="ELEMENT ELEMENT_DvOrdinal ">
                    <span class="label">Pupila izquierda:</span>
                    <span class="content">
                      <label class="field_451"/>
                    </span>
                  </div>
                  <div class="ELEMENT ELEMENT_DvOrdinal ">
                    <span class="label">Pupila derecha:</span>
                    <span class="content">
                      <label class="field_452"/>
                    </span>
                  </div>
                </span>
              </div>
              <div class="ELEMENT ELEMENT_DV_BOOLEAN ">
                <span class="label">Anisocoria:</span>
                <span class="content">
                  <label class="field_453"/>
                </span>
              </div>
            </span>
          </div>
          <div class="ELEMENT ELEMENT_DvOrdinal ">
            <span class="label">Sector espinal (Frankel):</span>
            <span class="content">
              <label class="field_454"/>
            </span>
          </div>
        </span>
      </div>
    </td>
    <td id="right">
      <div class="OBSERVATION  ">
        <span class="label">Escala de coma de Glasgow:</span>
        <span class="content">
          <div class="ELEMENT ELEMENT_DvOrdinal ">
            <span class="label">Mejor respuesta ocular:</span>
            <span class="content">
              <label class="field_9"/>
            </span>
          </div>
          <div class="ELEMENT ELEMENT_DvOrdinal ">
            <span class="label">Mejor respuesta verbal:</span>
            <span class="content">
              <label class="field_10"/>
            </span>
          </div>
          <div class="ELEMENT ELEMENT_DvOrdinal ">
            <span class="label">Mejor respuesta motora:</span>
            <span class="content">
              <label class="field_11"/>
            </span>
          </div>
          <div class="ELEMENT ELEMENT_DV_COUNT ">
            <span class="label">Escala final:</span>
            <span class="content">
(
    3
..
    15
)              <label class="field_12"/>
            </span>
          </div>
        </span>
      </div>
    </td>
  </tr>
  <tr>
    <td colspan="2" id="bottom">
      <div class="ACTION  ">
        <span class="label">Resumen de actuación:</span>
        <span class="content">
          <div class="ELEMENT ELEMENT_DV_TEXT ">
            <span class="label">Diagnóstico / Actuación:</span>
            <span class="content">
              <label class="field_137"/>
            </span>
          </div>
          <div class="ELEMENT ELEMENT_DV_DATE_TIME ">
            <span class="label">Fecha y Hora de evaluación:</span>
            <span class="content">
              <label class="field_138"/>
            </span>
          </div>
        </span>
      </div>
    </td>
  </tr>
</table>
